A 48-year-old woman with pemphigus vulgaris has both mucosal and cutaneous involvement. Her serum autoantibodies are most likely directed against which combination of desmogleins?

• A Desmoglein 1 only
• B Desmoglein 3 only
• C Desmocollin 1 and desmocollin 3
• D Both desmoglein 1 and desmoglein 3 ✓

Explanation

Mucosal-dominant pemphigus vulgaris shows anti-desmoglein 3 antibodies alone, whereas mucocutaneous pemphigus vulgaris shows antibodies against both desmoglein 3 and desmoglein 1. The presence of both correlates with cutaneous disease in addition to mucosal involvement. Option B applies to mucosal-limited disease. Option A is seen in pemphigus foliaceus. Desmocollins are targets in IgA pemphigus, not classical pemphigus vulgaris.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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